2 Course Outline – Session 1 Mental Health First AidCommon mental health problemsThe five basic steps of mental health first aidWhat are substance use disorders?Symptoms and risk factorsCrisis first aid for overdoseMental health first aid for substance use disordersTreatment and resources
3 Course Outline – Session 2 What is depression?Symptoms of depressionRisk factors for depressionAlcohol, drugs and depressionSuicide in CanadaCrisis first aid for suicidal behaviourMental health first aid for depressionTreatment and resources
4 Course Outline – Session 3 What are anxiety disorders?Symptoms of anxiety disordersRisk factors for anxiety disordersAlcohol, drugs and anxiety disordersCrisis first aid for panic attacksCrisis first aid for acute stress reactionMental health first aid for anxiety disordersTreatment and resources
5 Course Outline – Session 4 What are psychotic disorders?Symptoms of psychotic disordersRisk factors for psychosisAlcohol, drugs and psychotic disordersCrisis first aid for acute psychosisMental health first aid for psychosisTreatment and resourcesOther expressions of distress
6 World Health Organization Health is “a state of (complete) physical, mental and social well-being and not merely the absence of disease or infirmity.”Mental Health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”
7 The Mental Health Continuum Maximum Mental HealthMinimal Mental DisorderMinimal Mental HealthMaximum Mental DisorderDiagnosis of a serious illness and poor mental healthDiagnosis of a serious illness but copes well and has positive mental healthNo illness or disorder and positive mental healthNo diagnosable illness or disorder but has poor mental health
8 What are Mental Health Problems? A mental health problem causes major changes in a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work and carry on their usual personal relationships.
9 What is Mental Health First Aid? Mental Health First Aid is the help provided to a person developing a mental health problem or in a mental health crisis. The first aid is given until appropriate professional help is received or until the crisis is resolved.
10 Assess risk of suicide or harm Listen non-judgmentally The Five Basic StepsAssess risk of suicide or harmListen non-judgmentallyGive reassurance and informationEncourage the person to get appropriate professional helpEncourage self-help strategies
11 Why Mental Health First Aid? There is stigma associated with mentalhealth problemsImagine if we treated everyone like we treated the mentally ill.
14 Why Mental Health First Aid? There is stigma associated with mental health problemsMental health problems are commonMany people are not well informed about mental health/problemsProfessional help is not always on handPeople often do not know how to respond
15 PrevalenceAt least 1 in 3 Canadians will experience a mental health problem at some point in their lifeAt least 1 in 5 Canadians will experience a mental health problem in a yearIn Canada 20 per cent of all sick leaves are related to mental health
16 ImpactThe economic costs of mental illnesses in Canada was estimated to be at least $14.3 billion in 1998Mental illnesses are disablingSix of the 10 leading causes of ‘years lived with disability’ are mental health problems
17 The ALGEE Rap Assess situation and evaluate the risk Listen very carefully and don’t tsk tskGive reassurance and the good infoEncourage them to see appropriate proEncourage them to use self help ideasAnd that is the ALGEE rap my dears!
18 What is a Substance Use Disorder? Using alcohol or drugs does not in itself mean that a person has a substance use disorder (SUD)Dependence on a substanceUse leads to problems at work, school, homeUse causes damage to health
19 = One Standard Drink Table Wine 5 oz/142 mL (12% alcohol) Regular Beer Spirits1.5 oz/43 mL(40% alcohol)Centre for Addiction and Mental Health
20 Low-Risk Drinking Guidelines 0 drinks = lowest risk of an alcohol- related problemNo more than 2 standard drinks on any one dayWomen: up to 9 standard drinks a weekMen: up to 14 standard drinks a week
21 Long-Term Effects of Alcohol BrainHeartLungsLiver, pancreas, stomach and intestinesGenitals and reproductive systemMuscles, nervous system, motor skillsSkin
22 Other Abused Substances TobaccoNicotine is a powerful stimulantMale smokers are twice as likely to experience impotenceSpit tobacco contains more than 3,000 chemicalsWithdrawal symptoms include anxiety, insomnia, restlessnessSome long term effects - heart disease, stroke, cancer
23 Other Abused Substances Cannabis (marijuana, hashish, joints, reefers)Most widely used illegal drug in CanadaAbout 2% of the population have problem with cannabis abuse/dependence.More than twice as likely to suffer from an anxiety disorder or depressionMore than three times the risk of suffering from psychotic symptoms
24 Other Abused Substances Cannabis (marijuana, hashish, joints, reefers)Adolescents using cannabis are more likely to suffer from depression, conduct problems, drinking and other drug useMore frequent use of cannabis increases risk of diagnosis of schizophrenia over next 15 years
25 Other Abused Substances Amphetamines – a stimulant drugExamples: crystal meth, ice, speed, uppers, bennies, crank, ecstasyAmphetamines have the temporary effect of increasing energy and apparent mental alertnessUsers develop a tolerance and need to take more to get same effects
26 Other Abused Substances Amphetamines – a stimulant drugAn overdose can cause delusions, hallucinations, high fever, coma, deathA particular mental health risk is amphetamine psychosis or “speed psychosis” which involves symptoms similar to schizophrenia
27 Other Abused Substances OpioidsExamples: heroin, morphine, codeine, oxycodoneEffects can include pain relief, drowsiness, constipation, tiny pupilsUsers develop a tolerance and need to take more to get same effectsOverdose can result in coma and death
28 Other Abused Substances Cocaine (crack, coke, C, snow, flake)A cocaine high can last from 5 minutes to 2 hoursOverdose can cause seizures, strokes heart attacks, coma, deathUsers develop a tolerance and need to take more to get same effects
29 Risk Factors Family history of substance abuse Childhood abuse or neglectAcceptance of substance use (community, peer)Low parental support/monitoringPoor social skills
30 First Aid for Substance Use Disorders Assess risk of suicide or harmListen non-judgmentallyGive reassurance and informationEncourage the person to get appropriate professional helpEncourage self-help strategies
31 Step 1 Assess the Risk of Suicide or Harm If you determine the person has taken an overdose, follow the steps for Crisis First Aid for an OverdoseIf the person is not at risk, move on to Step 2 – Listen Non-Judgmentally
32 Crisis First Aid for an Overdose If they are unconscious:Make sure the person’s airway is clear and roll them into the recovery positionPhone 911 for an ambulanceTry to find out what substances were usedKeep the person warm, especially if alcohol is involved
33 Crisis First Aid for an Overdose If the person is consciousPhone or take the person to the nearest emergency departmentDo not give any food or fluidsReassure the personTry to find out what substances were usedKeep the person warm, especially if alcohol is involved
34 Step 2 Listen Non-Judgmentally Listen without interruptingAsk appropriate questions to make sure you are both clear on what is being saidListen to the word and tone of voice and watch their body languageRestate what the person has saidSummarize facts and feelings
35 Step 2 Listen Non-Judgmentally Be attentiveKeep eye contact comfortable (don’t stare or avoid eye contact)Keep an open body positionSit down, even if they standTry not to sit directly opposite (facing) the person
36 Step 3 Give Reassurance and Information Tell the person you want to help themSubstance use disorder is a real medical conditionIt is a common illnessPrograms are available to helpOften depressive and anxiety disorders underlie SUDs and can be treated
37 Step 4 Encourage the Person to Get Appropriate Professional Help Family doctor or physicianDrug and alcohol specialistsMental health team
38 The Change Model Contemplation Pre-contemplation Determination/ PreparationRelapseMaintenanceAction
39 Step 5 Encourage Self-Help Strategies Many people with a substance use disorder may also have another underlying mental health problem such as depression or anxiety.The self-help strategies for these conditions may help but should not be the main source of treatment.
40 Resources Alberta Alcohol and Drug Abuse Commission Centre for Addiction and Mental Health
41 If If you can always be cheerful If you can sleep without drugs If you can relax without alcoholIf you can start the day without caffeineIf you can take blame without resentmentIf you can resist without complainingIf you can eat the same food every day without complaining and be grateful
42 IfIf you can understand when your loved ones are too busy to spend time with youIf you can overlook it when those you love take things out on you when, through no fault of yours, something goes wrongThen you are almost as good as your dog
43 Session 2 What is depression? Symptoms of depression Risk factors for depressionAlcohol, drugs and depressionSuicide in CanadaCrisis first aid for suicidal behaviourMental health first aid for depressionTreatment and resources
44 What is Depression?Clinical depression lasts at least two weeks, affects the person’s behaviour and has physical, emotional and cognitive effects.It interferes with the ability to work and have satisfying personal relationships.
45 Symptoms of Depression Emotions: sadness, mood swings, hopelessness, anxietyThoughts: Self-criticism, indecisiveness, thoughts of suicide, pessimismBehaviour: Crying spells, neglect personal appearance, withdrawal, no motivationPhysical: Lack of energy, sleeping too much/too little, overeating/loss of appetite
46 Depression in the Workplace Decreased productivityMorale problemsLack of co-operationSafety problemsAbsenteeismComplaints of being tired, having aches/painsAlcohol and/or drug abuse
47 Bipolar Disorder (Manic Depression) Bipolar disorder is characterized by extreme mood swingsA person has periods of depression and mania with periods of ‘normal’ mood in betweenA person must have episodes of both depression and mania to be diagnosed
48 Symptoms of Bipolar Disorder DepressionManiaIncreased energy and over activityElated moodNeeding less sleep than usualIrritabilityRapid thinking and speechLack of inhibitionsGrandiose delusionsLack of insight
49 Risk Factors for Depression Break up of relationship or living in conflictHaving a babyJob loss, unsuccessful job huntingLong term illness or disability or caring for someone with illness/disabilityBeing a victim of a crimeAlcohol or drug abuse
50 Risk Factors for Depression Side effect of medications or drugsStress from another mental disorderHormonal changesLack of exposure to bright light in winterFamily history of depressionPrevious episodes of depressionDifficult childhood (abuse, neglect)
51 Suicide in Canada About 4,000 Canadians die by suicide each year In 2001, there were 3.5 suicides among men for every suicide among women. People in their 40s accounted for almost one in four suicides. Deaths by suicide surpassed deaths by motor vehicle accidents in that same year.
52 Suicide Rates by Province Per 100,000 population, 2001 186931215AlbertaSaskatchewanManitobaOntarioQuebecNew BrunswickNova ScotiaPrince Edward IslandCanadaBritish Columbia11.31013.27.716.511.414.110.4
53 First Aid for Depression Assess risk of suicide or harmListen non-judgmentallyGive reassurance and informationEncourage the person to get appropriate professional helpEncourage self-help strategies
54 Step 1 Assess the Risk of Suicide or Harm If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal BehaviourIf the person is not at risk, move on to Step 2 – Listen Non-Judgmentally
55 Crisis First Aid for Suicidal Behaviour Engage the person in serious conversation about how they are feelingDetermine if the person has thoughts of suicideExplore and assess the risk furtherFind out about prior suicidal behaviourFind out about their supports
56 Crisis First Aid for Suicidal Behaviour Ensure the person is not left aloneSeek additional helpIf they are consuming alcohol or drugs, try to ensure they do not take moreTry to ensure they do not have ready access to some means to take their lifeEncourage the person to talkEnsure your own personal safety
57 Self Care Supporting a suicidal person can be unsettling and stressful Do not underestimate the effect on your own well-beingFind ways of reducing the immediate stress (exercise, relaxation techniques, sleep)Find someone to talk to about your experience
58 Step 2 Listen Non-Judgmentally Listen to the person without judging.Do not be critical of the person.Do not express frustration with the person for having these symptoms.Do not give glib advice such as ‘pull yourself together’.Avoid confrontation unless necessary to prevent harmful acts.
59 Step 3 Give Reassurance and Information Depression is a real medical conditionDepression is a common illnessDepression is not a weakness or character defectDepression is not lazinessEffective help and treatments are available
60 Step 4 Encourage the Person to Get Appropriate Professional Help Community-based careFamily doctor or physicianCounsellors and clinical psychologistsPsychiatrists
61 What Helps for Depression? Very severe depression onlyElectroconvulsive therapy (ECT) Adults AdolescentsAntidepressantsRatingMedical Treatments Very good evidence Good evidence Promising treatment
64 What Helps for Depression? Reading depression self-help books based on CBTPsychodynamic psychotherapyInterpersonal psychotherapyCognitive behaviour therapy (CBT)RatingPsychological Treatments
65 Ten Common Thinking Distortions Black and white thinkingSetting unrealistic expectationsSelective thinkingConverting positives into negativesOver generalizingExaggerating unpleasantnessCatastrophizingPersonalizingMistaking feelings for factsJumping to negative conclusions
66 Step 5 Encourage Self-Help Strategies Self-help strategies have proven therapeutic effectsThey also help people to feel they are regaining control of their lives
67 What Helps for Depression? Massage therapyRelaxation therapyYoga breathing exercises Winter depression Non-seasonal depressionLight therapyExerciseRatingLifestyle & Alternative Treatments
68 What Helps for Depression? Alcohol avoidance – for people with drinking problemsFolateSt John’s wort*AcupunctureRatingLifestyle & Alternative Treatments* St John’s wort should not be taken with antidepressants. This herb has interactions with a number of prescribed medications.
74 ResourcesRefer to MHFA Canada Manual Section 2, page 11
75 Session 3 What are anxiety disorders? Symptoms of anxiety disorders Risk factors for anxiety disordersAlcohol, drugs and anxiety disordersCrisis first aid for panic attacksCrisis first aid for acute stress reactionMental health first aid for anxiety disordersTreatment and resources
76 What are Anxiety Disorders? An anxiety disorder differs from normal anxietyAnxiety disorders are more severe, they last longer and they interfere with work or relationshipsThere are several types of anxiety disorders – symptoms will vary.
77 Dizzy, disoriented, lightheaded? Mind Racing? Possible sleep disturbance?Vision strange or blurry?Difficulty swallowing?Feeling breathless, breathing fast & Shallow?Heart racing, palpitations?Nausea, lack of appetite?Trembling?Sweating or shivering?Restless?Jelly-like legs?Wanting to run?
78 General Symptoms of Anxiety PhysicalCardiovascular: palpitations, chest pain, rapid heartbeat, flushingRespiratory: hyperventilation, shortness of breathNeurological: dizziness, headache, sweating, tingling and numbness
79 General Symptoms of Anxiety PhysicalGastrointestinal: choking, dry mouth, nausea, vomiting, diarrheaMusculoskeletal: muscle aches and pains (esp. neck, shoulders), restlessness, tremors and shaking
80 General Symptoms of Anxiety PsychologicalUnrealistic and/or excessive fear and worry (about past or future events)Mind racing or going blankDecreased concentration and memory
81 General Symptoms of Anxiety PsychologicalDifficulty making decisions, confusionRestlessness, feeling ‘on edge’ or nervousnessTiredness, sleep disturbances, vivid dreamsIrritability, impatience, anger
82 General Symptoms of Anxiety BehaviouralAvoidance of situationsObsessive or compulsive behaviourDistress in social situationsPhobic behaviour
83 Types of Anxiety Disorders Generalized anxiety disorder (GAD)Panic disorder (with or without agoraphobia)AgoraphobiaSocial anxiety disorder (social phobia)Phobic disordersObsessive-compulsive disorder (OCD)Post traumatic stress disorder (PTSD)Acute stress disorder
84 Do You Worry All the Time? Which problems have you had often over the last 6 months?I never stop worrying about things big and smallI have headaches or aches and pains for no reasonI am tense a lot and have trouble relaxingI have trouble keeping my mind on things
85 Do You Worry All the Time? Which problems have you had often over the last 6 months?I get crabby or grouchyI have trouble falling asleep or staying asleepI sometimes have a lump in my throat or feel like I need to throw up when I am worriedI sweat and have hot flushes
86 Generalized Anxiety Disorder (GAD) Overwhelming and unfounded anxietyPhysical and psychological symptoms of anxiety and tension for more than 6 monthsGeneral worries over money, health and family etc. even when no problem exists
87 Do You Have Sudden Bursts of Fear for No Reason? Which problems have you had during these bursts of fear?I have chest pains or a racing heartI have a hard time breathing or a choking feelingI feel dizzy, or I sweat a lotI have stomach problems or feel like I need to throw up
88 Do You Have Sudden Bursts of Fear for No Reason? Which problems have you had during these bursts of fear?I shake, tremble, or tingleI feel out of controlI feel unrealI am afraid I am dying or going crazy
89 Panic Disorder A person with a panic disorder has panic attacks A panic attack is the sudden onset of intense fear or terrorThe attacks develop suddenlyThe fear is inappropriate for the circumstances in which it is occurring
90 Agoraphobia Fear of panic attacks Fear of being in a situation with no help or escapeAvoidance of places where it is felt that a panic attack could happen
91 Do You Feel Afraid or Uncomfortable When You are Around Other People? Is it hard to be at work or school?I have an intense fear that I will do or say something and embarrass myself in front of other peopleI am always very afraid of making a mistake and being watched and judged by other peopleMy fear of embarrassment makes me avoid doing things that I want to do or speaking to people
92 Do You Feel Afraid or Uncomfortable When You are Around Other People? Is it hard to be at work or school?I worry for days or weeks before I meet new peopleI blush, sweat, tremble, or feel like I have to throw up before or during an event where I am with new peopleI usually stay away from social situations such as school events and making speechesI often drink to try and make these fears go away
93 Social Anxiety Disorder Common anxiety disorderFear of humiliation, embarrassment or scrutiny by othersFear that others are thinking negatively about themTends to develop in shy children as they move into adolescence
94 Phobic DisordersA person with a phobia avoids or restricts activities because of fearThe fear appear persistent, excessive and unreasonableThe fear will cause the person to avoid specific things, events or places
95 Have You Lived Through a Very Scary or Dangerous Event? Which problems have you had after the event?I jump and feel very upset when something happens without warningI have a hard time trusting or feeling close to peopleI stay away from places that remind me of the eventI feel guilty because others died and I lived
96 Have You Lived Through a Very Scary or Dangerous Event? Which problems have you had after the event?I have trouble sleeping and my muscles are tenseI feel like the terrible event is happening all over again. This feeling often comes without warningI have nightmares and scary memories of the terrifying eventI get mad very easily
97 Post-Traumatic Stress Disorder and Acute Stress Disorder Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) occur after experiencing a distressing eventASD – distress is usually resolved within a monthPTSD – distress lasts longer than a month
98 Do You Feel Trapped in a Pattern of Unwanted and Upsetting Thoughts? Are any of these problems interfering with your life?I have upsetting thoughts or images enter my mind again and againI feel like I can’t stop these thoughts or images, even though I want toI worry a lot about terrible things that could happen if I’m not careful
99 Do You Feel Trapped in a Pattern of Unwanted and Upsetting Thoughts? Are any of these problems interfering with your life?I have unwanted urges to hurt someone but know I never wouldI have a hard time stopping myself from doing things again and again, like counting, checking on things, washing my hands, re-arranging objects, doing things until it feels right, collecting useless objects
100 Obsessive-Compulsive Disorder Obsessive thoughts and compulsive behaviours accompany feelings of anxiety.Obsessive thoughts are unwanted and inappropriate recurrent thoughts, impulses or images the person cannot get rid of.Compulsive behaviours are repetitive behaviours or mental acts such as counting, checking or washing.
101 Risk Factors for Anxiety Disorders GenderPeople with an anxious parentDifficult childhood (abuse, neglect)Some medical conditionsSide-effects of some prescription drugsSome non-prescription drugs (caffeine, amphetamines, cocaine, etc.)
102 First Aid for Anxiety Disorders Assess risk of suicide or harmListen non-judgmentallyGive reassurance and informationEncourage the person to get appropriate professional helpEncourage self-help strategies
103 Step 1 Assess the Risk of Suicide or Harm People with anxiety disorders are at greater risk of dying by suicide, particularly if they also have depression.If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour.If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally.
104 Crisis First Aid for Panic Attacks If you are unsure if it is a panic attack or a heart attack call an ambulance.If you are sure it is a panic attack, move the person to a quiet safe place.Help calm the person by helping them control their breathing.Be a good listener, without judging.
105 Crisis First Aid for Panic Attacks Explain they are having a panic attack and it is not life threatening.Explain the attack will be over soon and they will recover.Assure them that someone will stay with them until the attack stops.
106 Crisis First Aid for Acute Stress Reaction Let the person tell their story but do not push them to do so.Be a patient and sympathetic listener.Reassure the person that stress reactions are normal responses to abnormal events and in time most people have a normal recovery of their emotions.
107 Crisis First Aid for Acute Stress Reaction Encourage the person to share feelings with others.Advise the person not to use alcohol or drugs to cope.If the stress reaction persists for more than a month, encourage the person to seek professional help.
108 Step 2 Listen Non-Judgmentally YOU ARE NOT LISTENING TO ME WHEN:You say you understand.You say you have an answer to my problem, before I’ve finished telling you my problem.You cut me off before I’ve finished speaking.You finish my sentences for me.
109 Step 2 Listen Non-Judgmentally YOU ARE NOT LISTENING TO ME WHEN:You are dying to tell me something.You tell me about your experiences, making mine seem unimportant.You refuse my thanks by saying you really haven’t done anything.
110 Step 2 Listen Non-Judgmentally YOU ARE LISTENING TO ME WHEN:You try to understand me, even if I’m not making much sense.You grasp my point of view, even when it’s against your own sincere convictions.You realize the hour I took from you has left you a bit tired and a bit drained.
111 Step 2 Listen Non-Judgmentally YOU ARE LISTENING TO ME WHEN:You allow me the dignity of making my own decisions, even though you think they may be wrong.You do not take my problem from me, but allow me to deal with it in my own way.You hold back the desire to give me good advice.
112 Step 2 Listen Non-Judgmentally YOU ARE LISTENING TO ME WHEN:You do not offer me religious solace when I am not ready for it.You give me enough room to discover for myself what is really going on.You accept my gratitude by telling me how good it makes you feel to know that you have been helpful.
113 Step 3 Give Reassurance and Information Anxiety is a real medical condition.An anxiety disorder is a common illness.An anxiety disorder is not a weakness or character defect.Effective help and treatments are available.Anxiety can be unpleasant but is rarely harmful.
114 Step 4 Encourage the Person to Get Appropriate Professional Help Family doctor or physicianCounselling or psychotherapy for specific anxiety disorder
115 Step 5 Encourage Self-Help Strategies Anxiety is best overcome by confronting fear rather than avoiding itUse evidence-based self help booksPractice daily relaxation methods to reduce physical symptoms of tensionExercise regularly and get enough sleepReduce caffeine intakeEngage in leisure time
116 What Helps for Anxiety Disorders? Generalized anxiety disorderPhysical exerciseSpecific phobiasAnxiety DisorderAcupunctureRelaxation trainingCBT self-help booksRatingTreatments
117 What Helps for Anxiety Disorders? Generalized anxiety disorderMeditationRange of anxiety disordersAnxiety DisorderAlcohol AvoidanceRelaxing MusicRatingTreatments
118 ResourcesRefer to MHFA Canada Manual Section 3, page 10
119 Session 4 What are psychotic disorders? Symptoms of psychotic disordersRisk factors for psychosisAlcohol, drugs and psychotic disordersCrisis first aid for acute psychosisMental health first aid for psychosisTreatment and resourcesOther expressions of distress
120 What is Psychosis?Psychosis is a mental health problem in which a person has lost some contact with realitySevere disturbances in thinking, emotion and behaviourPsychotic illnesses are not common compared to other mental health problems
121 What is Psychosis?Psychosis may appear as a symptom in a number of mental health problems including:SchizophreniaSchizoaffective disorderBrief psychotic disorderPsychotic disorder due to a general medical conditionSubstance induced psychotic disorder
122 Symptoms of Psychosis Changes in emotion and motivation Depression or anxietySuspiciousnessBlunted, flat or inappropriate emotionIrritabilityChange in appetiteReduced energy and motivation
123 Symptoms of Psychosis Changes in thinking and perception Difficulties concentratingSense of alteration of self or others – feeling that self or others have changed or are acting differentlyOdd ideasUnusual perceptual experiences – reduced or greater intensity of smell, sound, colour
124 Symptoms of Psychosis Changes in behaviour Sleep disturbance Social isolation or withdrawalReduced ability to work or carry out social rolesOdd or strange behaviour
125 Symptoms of Psychosis Changes in speech Disorganized speech Speech becomes rapid
126 Schizophrenia Schizophrenia is a chronic and disabling disorder Mental function changes and thoughts and perceptions become disorderedSchizophrenia is not a constant or static condition – severity of symptoms fluctuate or do not appear at all
127 Symptoms of Schizophrenia DelusionsHallucinationsThinking difficultiesLoss of driveBlunted emotionsSocial withdrawal
128 Other Psychotic Disorders Psychotic depression – a depression so intense it causes psychotic symptomsSchizoaffective disorder – Symptoms of both schizophrenia and mood disorder (depression, bipolar disorder)Substance induced psychosis – psychosis brought on by drug use. Drug use may also trigger another psychotic illness such as schizophrenia
129 Risk Factors for Psychotic Disorders It is believed that psychosis is caused by a combination of factors including:GeneticsBiochemistryStress
130 First Aid for Psychotic Disorders Assess risk of suicide or harmListen non-judgmentallyGive reassurance and informationEncourage the person to get appropriate professional helpEncourage self-help strategies
131 Step 1 Assess the Risk of Suicide or Harm Psychotic disorders involve high risk of suicideIf you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal BehaviourIf the person is not at risk, move on to Step 2 – Listen Non-Judgmentally
132 What if a Psychotic Person is Threatening Violence? Do not get involved physicallyCall the policeTry to create a calm, non-threatening atmosphereTry to get the person to sit downDo not try to reason with acute psychosisExpress empathy for the person’s emotional distressComply with reasonable requests
133 Step 2 Listen Non-Judgmentally Listen to the person without judgingSpeak calmly, clearly and in short sentencesDo not be critical of the person and do not express frustration with the personDo not give glib advice such as ‘pull yourself together’
134 Step 2 Listen Non-Judgmentally Avoid confrontation unless necessary to prevent harmful actsDo not argue with the person about their delusions and hallucinations but do not pretend they are real to you
135 Step 3 Give Reassurance and Information When a person is in a psychotic state it is difficult and inappropriate to give them information about psychosis – wait until they are in touch with realityDo not make promises you cannot keep and do not lie
136 Step 3 Give Reassurance and Information When the person is thinking more clearly explain:You want to help themThey have a real medical conditionTheir condition is not a common illness but well known and researchedPsychosis is not a weakness or character defectEffective medications are available
137 Step 4 Encourage the Person to Get Appropriate Professional Help Early intervention is important. The person needs to be placed on appropriate medicationFamily doctor or physicianPsychiatristCommunity mental health teamsFamily and friends
138 Step 5 Encourage Self-Help Strategies Have an agreement with family/friendsMany people with a psychotic disorder also have depression and/or anxietyThe self-help strategies for these conditions may help but should not be the main source of treatment
139 ResourcesRefer to MHFA Canada Manual Section 4, page 8